The ISS (Immune Suppression Syndrome) Clinic in Mbarara University of Science and Technology (MUST) and Mbarara Regional Referral Hospital (MRRH) has provided HIV Care since November 1998 under the headship of Dr. Winnie Muyindike and Dr.Nansera Denis. Even when the section heads may appear to have an affiliation to the Regional Referral Hospital; they are still supervised by the University Departments under the Faculty of Medicine.
The clinic has two sections;
The Adult care section, under the Department of Internal Medicine
The adult care section has taken care of a cumulative number of 26,000 adult HIV infected patients (Active adults in care are 11,000 of which 97% are on ART. The difference in cumulative and active numbers is brought about by some Deaths, some Lost to Follow up patients whose whereabouts we can’t be certain about, those transferred out to lower ART centers which mushroomed when ART services were rolled out to lower centres).
The Paediatric and adolescents care section under the Department of Pediatrics
The Paediatric and adolescents care section has cared for a cumulative number of 3000 HIV Infected children (Active in care is about 900 HIV infected children including adolescents, All on ART) and has cared for over 4000 exposed HIV infants (born to HIV infected mothers) of which a small % (< 4%) turned HIV +especially those belonging to mothers who didn't have ART in ANC or who started ARVs very late in Pregnancy etc due to attending ANC in different centres not offering PMTCT then.
The ISS Clinic Institution is blessed to have a number of partners supporting it in different ways, some of whom are still providing support, while others have since ceased:
Makerere University Joint AIDS Program (MJAP) - 2004 Sept to date
MJAP has provided partnership and support for Staffing, Laboratory services for the patients and Technical building of Skills for staff both in Hospital and University in HIV/AIDS skills.
Joint Clinical Research Centre – Uganda (JCRC) - 2003 to date
JCRC has provided infrastructure support as well as support in doing Clinical Research Trials. In addition, it has carried out capacity building of ISS staff through trainings in Mentorship, GCP/GCLP etc. It originally also had a Care Program (TREAT).
University of California San Francisco (UCSF)
The University of California San Francisco (UCSF) is supporting the Open Medical Records system in ISS clinic. This is a large electronic database supported by a research grant under IEDEA (International Epidemiologic Databases to Evaluate AIDS).
Doing Clinical Research Trials and has been very instrumental in help with TB diagnosis eg Gene-xpert testing before MoH got its equipment. It is now doing a program to screen all HIV + Patients for Hep C virus etc. It also supports some infrastructure remodeling eg Lab space
Massachusetts General Hospital (MGH)
MGH has supported the ISS clinic in conducting Research studies which has led to many publications so far under Dr. David Bangsberg and other officers under his mentorship. It also provides some clinical/research/public Health specialists who help conduct a few lectures for postgraduates in internal medicine.
Canada-Africa Prevention Trials Network (CAPTN)
This network has supported several University and Hospital staff with small Research funding/scholarships through individual application. Although the funding has ended, it has been used to support Discordant couple meetings which have since then been taken over by MJAP.
Facilities available for Researchers
A rich electronic database for adult HIV infected patients with data from enrollment of patients to date (apart from if they are lost to follow up or dead or transferred out ). This is available for all faculty members, students and all other researchers in University/Hospital as long as the MUST REC has approved their Research Protocols and the Hospital Director has permitted use of the patients’ information. There is also a small ISS Clinic data sharing committee headed by Dr Bwana (the co-investigator of IEDEA) which receives a formal request for the variables needed and permits it.
Availability of patients in HIV care. These are vulnerable participants so the researchers need to be mindful as they come in to do research on these patients.
Ministry of Health Hard Registers also contain information relevant to research in HIV.
The JCRC Lab possesses updated equipment which can be utilized by researchers.